RYAN MCCULLOCH, PA
Physician Assistant
Active
Individual
NPI: 1720195530
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | PA405 (ID) |
Frequently Asked Questions
NPI 1720195530 is the National Provider Identifier for RYAN MCCULLOCH, PA, a Physician Assistant provider located in Chubbuck, ID. This NPI was enumerated on August 25, 2006.
RYAN MCCULLOCH, PA practices at 147 W CHUBBUCK RD, Chubbuck, ID 83202.
Quick Facts
- NPI
- 1720195530
- Type
- Individual
- Enumerated
- Aug 25, 2006
- Last Updated
- Dec 20, 2010
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